Direct Hospitalization Cost of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam

Ngo, Chau Quy; Bui, Thuy Thi; Vu, Giap Van; Chu, Hanh Thi; Phan, Phuong Thu; Pham, Ha Ngoc; Vu, Giang Thu; Nguyen, Long H.; Ha, Giang Hai; Tran, Bach Xuan; Latkin, Carl A.; Ho, Cyrus S.H.; Ho, Roger

doi:10.3390/ijerph16010088

Cited by 11 publications

(11 citation statements)

References 21 publications

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“…The prevalence of diabetes in this study was underestimated due to the lack of screening programs for diabetes. Moreover, the prevalence of diabetes in this study is close to 12.3% reported by Ngo et al [ 24 ], lower than 25.3% reported by Terzano et al [ 25 ] and 26.3% reported by Perera et al [ 26 ]. Except for prevalence underestimation, comparing to the study of Terzano et al, this is probably due to younger age of participants in our study.…”

Section: Discussionsupporting

confidence: 69%

Outcomes associated with comorbid diabetes among patients with COPD exacerbation: findings from the ACURE registry

Mao¹,

Liang²,

Niu

et al. 2021

Respir Res

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Background Diabetes is a common comorbidity among patients with exacerbation of chronic obstructive pulmonary disease (AECOPD). Diabetes has been reported to be associated with length of stay (LOS), death, and cost among AECOPD patients. However, most studies are retrospective or have small sample sizes. The association for cost has not been researched using diabetes as a main analytic factor. This study aimed to fill gaps mentioned above, to compare basic characteristics between the diabetic and non-diabetic group, and to detect associations between diabetes and clinical outcomes among patients hospitalized with AECOPD. Methods A total of 5334 AECOPD patients, classified into diabetic and non-diabetic group, were included from a prospective multicenter patient registry study. Generalized linear regression and logistic regression were separately used for the association between diabetes and direct hospitalization cost and the association between diabetes and LOS. Results Generally, diabetic patients had a more severe profile, including being older, more overweight or obese, having more former smokers, more emergency room visits in the past 12 months, and more comorbidities occurrence. Diabetic patients also had worse clinical outcomes, including higher cost and longer LOS. Additionally, the generalized linear regression indicated that the marginal mean cost difference between diabetic and non-diabetic patients was RMB (¥) 775.7. Conclusions AECOPD patients with comorbid diabetes had a more severe profile and higher direct hospitalization cost. Diabetes screening and integrated care programs might help reduce the heavy comorbidity and economic burden. Moreover, corticosteroids and metformin could be considered in the treatment of these patients. Trial registration Clinicaltrials.gov with the identifier NCT0265752.

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Section: Discussionsupporting

confidence: 69%

Outcomes associated with comorbid diabetes among patients with COPD exacerbation: findings from the ACURE registry

Mao¹,

Liang²,

Niu

et al. 2021

Respir Res

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“…Another study conducted among patients hospitalized with acute coronary syndrome in eight Asian countries in 2013 found a mean length of stay of 10 days and per day cost in a critical unit that ranged from int $3210 in Singapore, int$ 284 in Thailand to int$ 98 in Vietnam [18]. For COPD patients, mean hospitalization costs were US$ 3,670 in China [16] and US$ 795 in Vietnam [17]. Our ndings are in the low range of these numbers with mean costs of INT $722 (sd=418), and cost per day below $100.…”

Section: Discussionmentioning

confidence: 99%

“…The most studied factors that contribute to high inpatient costs in LMICs were age, gender, comorbidities, length of stay, and type of health care providers [15]. Disease-speci c factors that drive inpatient costs were type of stroke in China [16] and lung function for patients with COPD in Vietnam [17], both re ecting disease severity. Disease-speci c costing studies thus far were typically conducted in a single hospital and were limited by small sample size.…”

Section: Introductionmentioning

confidence: 99%

The Cost of Inappropriate Referral Pathways in Inpatient Care for Three Major Noncommunicable Diseases in Mongolia: A Registry-Based Analysis

Tuvdendorj

Dechinkhorloo²,

Bayarsaikhan

et al. 2021

Preprint

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Background: Non-communicable diseases (NCDs) consistently pose a huge economic burden to health systems and countries in general. The aim of this study was to quantify inpatient costs associated with chronic obstructive pulmonary disease, stroke and ischemic heart disease stratified by type of referral pathway, and to investigate key factors that drive these costs. Methods: A registry-based data analysis was performed using national public hospital inpatient records from 2016 to 2018 for 117,600 unique patients and linking patient-level inpatient health care use with hospital-specific unit cost per bed-day. These were combined to calculate the annual inpatient costs for each of the three disorders per person and per year. Generalized linear modeling was used to assess the association of inpatient costs with age, gender, location, comorbidity, treatment referral pathways and years.Results: Across three diagnoses, the majority of patients were female. Most were over 50-60 years old, with more than half being a pensioner, typically with at least one comorbidity. About 25% of patients followed what might be considered inappropriate (unofficial) inpatient referral pathways. Mean annual inpatient costs were int$ 721. These costs rose to int$ 849 for unofficial pathways and dropped to int$677 for official pathways. Further covariates significantly associated with high inpatient costs were location, age, gender, and comorbidity. Conclusion: Our findings provide background information essential to develop evidence-based and cost-effective interventions aimed at health promotion, prevention and service delivery. Reducing the unofficial use of inpatient care can improve efficient resource allocation in health care and prevent further escalation of inpatient costs in the future.

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“…A cross-sectional Vietnamese study reported a statistically significant difference in mean total cost per hospitalization for an exacerbation of COPD between GOLD groups (6.4 million Vietnamese dong [VND] vs 14.1 million VND [p<0.05], for GOLD A and GOLD B, respectively). 59 A Danish registry study (2008–2017) reported total annual direct costs per patient to be higher in GOLD B versus GOLD A (€12,884 vs €8687, respectively) and lowest for GOLD A across all GOLD groups. 60 A Bulgarian study reporting indirect costs across GOLD A and B groups estimated that the total mean indirect costs per patient per year were higher for GOLD B versus GOLD A (€692.51 vs €575.11, respectively [p<0.001]).…”

Section: Resultsmentioning

confidence: 99%

Burden of Disease in Patients with Mild or Mild-to-Moderate Chronic Obstructive Pulmonary Disease (Global Initiative for Chronic Obstructive Lung Disease Group A or B): A Systematic Literature Review

Czira¹,

Purushotham²,

Iheanacho³

et al. 2023

COPD

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Background Patients with mild or mild-to-moderate chronic obstructive pulmonary disease (COPD), defined as Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A/B, are regarded as having a lower risk of experiencing multiple or severe exacerbations compared with patients classified as GOLD group C/D. Current guidelines suggest that patients in GOLD A/B should commence treatment with a bronchodilator; however, some patients within this population who have a higher disease burden may benefit from earlier introduction of dual bronchodilator or inhaled corticosteroid-containing therapies. This study aimed to provide research-based insights into the burden of disease experienced by patients classified as GOLD A/B, and to identify characteristics associated with poorer outcomes. Methods A systematic literature review (SLR) was conducted to identify evidence (burden of disease and prevalence data) relating to the population of interest (patients with COPD classified as GOLD A/B). Results A total of 79 full-text publications and four conference abstracts were included. In general, the rates of moderate and severe exacerbations were higher among patients in GOLD group B than among those in group A. Among patients classified as GOLD A/B, the risk of exacerbation was higher in those with more symptoms (modified Medical Research Council or COPD Assessment Test scales) and more severe airflow limitation (forced expiratory volume in 1 second % predicted). Conclusion Data from this SLR provide clear evidence of a heavier burden of disease for patients in GOLD B, compared with those in GOLD A, and highlight factors associated with worse outcomes for patients in GOLD A/B.

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Direct Hospitalization Cost of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Vietnam

Cited by 11 publications

References 21 publications

Outcomes associated with comorbid diabetes among patients with COPD exacerbation: findings from the ACURE registry

Outcomes associated with comorbid diabetes among patients with COPD exacerbation: findings from the ACURE registry

The Cost of Inappropriate Referral Pathways in Inpatient Care for Three Major Noncommunicable Diseases in Mongolia: A Registry-Based Analysis

Burden of Disease in Patients with Mild or Mild-to-Moderate Chronic Obstructive Pulmonary Disease (Global Initiative for Chronic Obstructive Lung Disease Group A or B): A Systematic Literature Review

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